Ministry of Health & Family Welfare GOI 12.09.2012

1. National Programme for Prevention and Control of Cancer, Diabetes, CVDs and Stroke (NPCDCS) Ministry of Health & Family Welfare GOI 12.09.2012

2. NCDs in India: Disease burden Diabetes • 2000: 2.58 crore (NCMH) • 2011: 6.1 crore (IDF) • 2030: 10.1 crore (IDF) Cardio-vascular Diseases • 1998: 1.9 crore (ICMR) • 2005: 3.8 crore(NCMH) • 2015: 6.4 crore(NCMH) Cancer • Estimated number of persons with cancer: 28 lakh • Annual Incidence: 11 lakh (ICMR) • Estimated annual deaths : 5 lakh

3. Existing Program components • National NCD cell • State NCD cell • Tertiary Cancer Centers • District NCD cell • District NCD clinic • Day Care Cancer Centre • Cardiac Care Unit (CCU) • CHC NCD clinic • Sub centre – screening • Health Promotion • Training • Monitoring including database

4. Challenges

5. Cardiac Care Unit (CCU) • Support of Rs. 1.5 crores • Functional in 20 districts so far CCU at Pattanamthita, Kerala CCU at Kupwara, J&K • Issues: • Procurement of equipments • Non availability of specialists • Lack of space in some district hospitals

6. Day Care Cancer Facility(Chemotherapy) • Support of Rs. 1.66 crores: Rs. 1 crore for chemotherapy & Rs. 66 lakhs for other components • Functional in 4 districts so far (Mewat, Leh, E.Sikkim & Pathanamthitta) • Issues: • Non availability of specialists • Lack of space in some district hospitals • Linkage with TCC District Cancer Facility, Kerala District Cancer Facility, Mewat

7. Human Resource • Support for contractual manpower at State NCD cell, District NCD cell, NCD Clinic at district hospital, Cardiac Care Unit, Day care Cancer Facility & NCD clinic at CHC • Issues: • State recruitment procedures • Relaxation in term of references ( age, qualification)

8. Tertiary Cancer Centres • 65 TCCs to be funded in 2010-11 & 2011-12 • 50 proposals received • Eight TCCs given assistance of Rs. 4.8 crore each (i.e. 80% central share) Criteria for assistance • Govt. medical College & RCCS • State recommendation, Atomic Energy Regulatory • Board (AERB} clearance, manpower availability • Separate MOU required( Tripartite) • Issues: • Less new proposals • Incomplete proposals

9. Screening for Diabetes and Hypertension -1 Logistics & training provided: • Training to Health Workers : completed in 82 districts (out of 100 • districts, 4 districts of TN : logistics not required) • Target population : 5.6 crore • Screened: 1.02 crore, 3.48 to be screened • Suspected for diabetes : 7.5 lakh (7.4%) • Suspected for hypertension :6.5 lakh (6.5%)

10. Financial status (Rs. in crore) • 20 % state share contribution • 4 States (Gujarat, Kerala ,Odisha & WB) contributed • complete share • 3 states (Chhattisgarh, Maharashtra & Rajasthan ) • contributed partially • No information from remaining 13 states so far.

11. Other issues • Dedicated SNO& DNO • SOEs, UCs & audited account statement • Refrral • Analysis& regular reporting • Health promotion and mainstreaming

12. 12th Plan Proposal -1 • Thrust on health promotion • Screening for diabetes and hypertension to be continued • PHCs to be included under the programme • Screening of common cancers ( oral, breast and cervical) at CHC and above • Cardiac Care unit / Intensive Care Unit (ICU) in at least 25% district hospitals, wherever feasible • Linkages with Medical Colleges for mentoring the districts and to provide outreach and referral services

13. 12th Plan Proposal- 2 • Screening of diabetes and hypertension in urban slums in 33 cities of more than one million population • Chemotherapy facilities in at least 25% of district hospitals, where ever feasible. • Establishment of 20 State Cancer Institutes & 50 Tertiary Cancer Centres with augmented funding • Government of India (GOI) and State share : 75: 25 90: 10in North East and hilly states under NPCDCS

14. Thank You